Chemsex is a growing concern among men who have sex with men (MSM). COVID-19 lockdowns have had consequences on social and sexual interactions. We aimed to assess changes in chemsex practices during ...COVID-19 lockdown in France among MSM and factors associated with maintaining or increasing chemsex practice.
Repeated face-to-face questionnaires were conducted at "Le 190" Sexual Health Center, Paris, France, exploring lifestyle, sexual, and chemsex practices, COVID-19 concerns and mental health before and during second lockdown in France (30/10/2020-15/12/2020). Inclusion criteria were chemsex practices at least 3 times throughout lifetime and at least once in the 3 months before second lockdown. The primary end point was the proportion of participants who declared having stopped, decreased, maintained, or increased their chemsex practice during lockdown. Univariable and multivariable logistic regressions were used to analyze factors associated with evolutions of chemsex practice.
Ninety-three MSM were included: 66% HIV-positive and 30% taking PrEP. Drugs most used were cathinones (91%) and GHB/GBL (52%). Participants reported stopping, decreasing, maintaining, and increasing chemsex drugs use in 14%, 22%, 22%, and 42% of cases, respectively. Despite this overall increase in chemsex practice, MSM decreased their number of sexual partners. Factors significantly associated with maintaining or increasing chemsex drugs use were feeling lonely (OR = 3.24), craving (OR = 4.51), and working during lockdown (OR = 3.27), contrasting with fear of COVID-19 (OR = 0.31).
Restriction measures lead to changes in sexual behavior and seem to increase chemsex practice. Maintaining care for most isolated patients should be a priority in COVID-19 context.
HIV self-tests (HSTs) have been deployed to reduce the burden of undiagnosed HIV infections in subpopulations undertested. We assumed that patients attending sexual health centres could themselves ...distribute HSTs in their close network. This study aimed to assess the proportion and the characteristics of the participants who distributed HSTs, as well as the characteristics of people who received HSTs.
Three HSTs were given to patients attending "Le 190" Sexual Health Center, Paris, France, having consented for the study, between July 2018 and August 2020. Participants had to distribute HSTs within 6 months, preferably to individuals in their close circle who have not been tested for a long time. Then they had to complete a self-questionnaire, exploring HIV status, sexual practices, number of distributed HSTs, profile of persons who received HSTs, and if known, result of used HSTs. Univariable logistic regression was used to determine factors associated with HST distribution.
Overall, 682/1062 (64%) patients accepted to be included in the study, and 283/682 (42%) completed the questionnaire. 97% were men who have sex with men (MSMs), including 86 (30%) HIV-positive individuals and 119 (42%) HIV Pre-Exposure Prophylaxis (PrEP) users. The proportion of participants having distributed 0, 1, 2 or 3 HSTs was 31%, 15%, 27% and 27%, respectively. Participants having distributed at least one HST (n=195, 69%) were more likely to have previously used HSTs themselves (OR=3.90, 95% CI=1.84 to 8.29, p<0.001). On the 901 HSTs in possession of participants who answered the questionnaire, 455 (50%) were distributed. 79% of recipients were MSMs, and 42% of whom had not been tested for more than 1 year. The result was known for 220 HSTs, including 5 positive (2.3%).
MSMs attending sexual health centres could be good disseminators of HSTs, targeting a population with high level of undiagnosed HIV infections, especially if they have already experimented it.
•High clustering of acute hepatitis C virus (HCV) infections among Parisian human-immunodeficiency-virus-positive male patients.•High rate of associated sexually transmitted infections.•Call for ...rapid treatment of both chronic and acute HCV infections.•Need for preventive behavioural interventions.
Increasing incidence of hepatitis C virus (HCV) infection in human immunodeficiency virus (HIV)-positive men having sex with men (MSM) has been described in recent years. Phylogenetic analyses of acute HCV infections were undertaken to characterize the dynamics during the epidemic in Paris, and associated sexually transmitted infections (STIs) were evaluated.
Sanger sequencing of polymerase gene was performed. Maximum likelihood phylogenies were reconstructed using FastTree 2.1 under a GTR+CAT model. Transmission chains were defined as clades with a branch probability ≥0.80 and intraclade genetic distances <0.02 nucleotide substitutions per sites. STIs detected ≤1 month before HCV diagnosis were considered.
Among the 85 studied patients, at least 81.2% were MSM. Respectively, 47.6%, 39.0%, 11.0% and 2.4% were infected with genotypes 1a, 4d, 3a and 2k. At least 91.8% were co-infected with HIV. HCV re-infection was evidenced for 24.7% of patients and STIs for 20.0% of patients. Twenty-two transmission chains were identified, including 52 acute hepatitis C (11 pairs and 11 clusters from three to seven patients).
These results revealed strong clustering of acute HCV infections. Thus, rapid treatment of both chronic and acute infections is needed among this population to decrease the prevalence of HCV, in combination with preventive behavioural interventions.
Le 190 est un centre de santé sexuelle parisien créé en 2010. Son objectif initial est de faire baisser localement l’épidémie de VIH/sida chez les hommes ayant des relations sexuelles avec d’autres ...hommes (HSH) via un accompagnement pluridisciplinaire et ancré dans la réalité de la sexualité et de la vie affective des HSH séropositifs et séronégatifs. Du fait d’une préoccupation constante pour la santé globale gay et de son caractère communautaire, son activité s’est diversifiée et lui a permis d’être précurseur à la fois dans le soin et les parcours de soin, sous le double aspect médical et réglementaire. La santé mentale et les complications du chemsex prennent une place de plus en plus importante dans la demande de soin et l’accompagnement s’est adapté et perfectionné avec les patients. Aujourd’hui considéré comme un modèle par de nombreux acteurs communautaires et soignants, Le 190 fête ses treize ans, l’occasion de partager son expérience et de réaffirmer son intérêt démontré pour la santé publique et le soin universel. Les innovations majeures du centre ainsi que les limites et difficultés qu’il a pu rencontrer permettront de mieux appréhender la santé communautaire sur le terrain et plus particulièrement la santé communautaire gay.
One year after the occurrence of the first case of infection by the Middle East Respiratory Syndrome coronavirus (MERS-CoV) there is no clear consensus on the best treatment to propose. The World ...Health Organization, as well as several other national agencies, are still working on different clinical approaches to implement the most relevant treatment in MERS-CoV infection. We compared innate and adaptive immune responses of two patients infected with MERS-CoV to understand the underlying mechanisms involved in the response and propose potential therapeutic approaches. Broncho-alveolar lavage (BAL) of the first week and sera of the first month from the two patients were used in this study. Quantitative polymerase chain reaction (qRTPCR) was performed after extraction of RNA from BAL cells of MERS-CoV infected patients and control patients. BAL supernatants and sera were used to assess cytokines and chemokines secretion by enzyme-linked immunosorbent assay. The first patient died rapidly after 3 weeks in the intensive care unit, the second patient still recovers from infection. The patient with a poor outcome (patient 1), compared to patient 2, did not promote type-1 Interferon (IFN), and particularly IFNα, in response to double stranded RNA (dsRNA) from MERS-CoV. The absence of IFNα, known to promote antigen presentation in response to viruses, impairs the development of a robust antiviral adaptive Th-1 immune response. This response is mediated by IL-12 and IFNγ that decreases viral clearance; levels of both of these mediators were decreased in patient 1. Finally, we confirm previous in vitro findings that MERS-CoV can drive IL-17 production in humans. Host recognition of viral dsRNA determines outcome in the early stage of MERS-CoV infection. We highlight the critical role of IFNα in this initial stage to orchestrate a robust immune response and bring substantial arguments for the indication of early IFNα treatment during MERS-CoV infection.
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Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
A general quantum circuit can be simulated classically in exponential time. If it has a planar layout, then a tensor-network contraction algorithm due to Markov and Shi has a runtime exponential in ...the square root of its size, or more generally exponential in the treewidth of the underlying graph. Separately, Gottesman and Knill showed that if all gates are restricted to be Clifford, then there is a polynomial time simulation. We combine these two ideas and show that treewidth and planarity can be exploited to improve Clifford circuit simulation. Our main result is a classical algorithm with runtime scaling asymptotically as n ω / 2 < n 1.19 which samples from the output distribution obtained by measuring all n qubits of a planar graph state in given Pauli bases. Here ω is the matrix multiplication exponent. We also provide a classical algorithm with the same asymptotic runtime which samples from the output distribution of any constant-depth Clifford circuit in a planar geometry. Our work improves known classical algorithms with cubic runtime.A key ingredient is a mapping which, given a tree decomposition of some graph G , produces a Clifford circuit with a structure that mirrors the tree decomposition and which emulates measurement of the corresponding graph state. We provide a classical simulation of this circuit with the runtime stated above for planar graphs and otherwise n t ω − 1 where t is the width of the tree decomposition. Our algorithm incorporates two subroutines which may be of independent interest. The first is a matrix-multiplication-time version of the Gottesman-Knill simulation of multi-qubit measurement on stabilizer states. The second is a new classical algorithm for solving symmetric linear systems over F 2 in a planar geometry, extending previous works which only applied to non-singular linear systems in the analogous setting.
Discovery efforts leading to the identification of ervogastat (PF-06865571), a systemically acting diacylglycerol acyltransferase (DGAT2) inhibitor that has advanced into clinical trials for the ...treatment of non-alcoholic steatohepatitis (NASH) with liver fibrosis, are described herein. Ervogastat is a first-in-class DGAT2 inhibitor that addressed potential development risks of the prototype liver-targeted DGAT2 inhibitor PF-06427878. Key design elements that culminated in the discovery of ervogastat are (1) replacement of the metabolically labile motif with a 3,5-disubstituted pyridine system, which addressed potential safety risks arising from a cytochrome P450-mediated O-dearylation of PF-06427878 to a reactive quinone metabolite precursor, and (2) modifications of the amide group to a 3-THF group, guided by metabolite identification studies coupled with property-based drug design.
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